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Queen’s University leading cell therapy clinical trial to help improve outcomes in COVID-19 patients

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Technology transfer moves more than manufacturing instructions. It moves process knowledge, supplier dependencies, labeling requirements, packaging specifications, and the evidence needed to demonstrate control. For medical device manufacturers, including those supporting drug-device combination products, these interfaces can become recurring sources of compliance gaps during site transitions, acquisitions, and remediation. The central problem is often not a missing procedure. It is a quality system that allows connected activities to change independently. A label revision may be approved while packaging artwork, supplier instructions, or production-system data still reflect an obsolete version. Staying inspection-ready requires manufacturers to manage these dependencies as one controlled system. 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Transitions expose unresolved weaknesses Acquisitions and site transfers can introduce conflicting procedures, incomplete knowledge transfer, or different assumptions about validated processes. Regulatory changes add further demands. When these events coincide with CAPA or change-control backlogs, teams may prioritize administrative closure over risk reduction. Without a coordinated impact assessment, local fixes can create new gaps downstream. Establish the Regulatory Baseline Inspection readiness starts with knowing which requirements apply to the product, activity, and market. Pharmaceutical, device, and combination-product obligations are not interchangeable; transfer planning should identify the applicable requirements rather than assume one quality framework covers every operation. 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How to Identify the Real Gaps Begin with a cross-functional assessment that follows actual product and information flows. Select representative transfers, label changes, supplier changes, and CAPAs, then trace each from initiation through implementation and effectiveness review. Map dependencies: Identify affected specifications, suppliers, packaging components, systems, validation activities, and training. Compare records with practice: Check whether approved procedures match what operators and reviewers actually do. Test traceability: Follow a requirement through technical documentation, labeling, production instructions, and release evidence. Examine recurrence: Look for repeated deviations, reopened actions, overdue changes, and findings shared across sites. Assess capacity: Determine whether qualified owners have enough time and authority to complete corrective work. Prioritize gaps by potential patient or user harm, regulatory impact, likelihood of recurrence, and detectability. Document the rationale; an old overdue item is not automatically more important than a newly identified high-risk weakness. Align Quality, Labeling, Packaging, and Change Control Create a coordinated remediation plan with one accountable owner for each action, named contributors, acceptance criteria, and required evidence. Separate immediate containment from systemic correction. Containment might prevent obsolete labels from being issued; correction might redesign approval and implementation controls so obsolete versions cannot return. Use change control as the integration point. Before approval, evaluate effects on regulatory submissions or notifications, technical documentation, supplier controls, packaging performance, validation, electronic master data, inventory, and training. Record both identified impacts and justified decisions that particular activities are unaffected. During technology transfer, define readiness gates before production or release responsibilities move. These should address the transfer of process knowledge, acceptance criteria, receiving-site capability, required qualification or validation, approved documents, and personnel competence. The appropriate evidence depends on the product and process; a generic checklist cannot replace a documented assessment. Finally, verify implementation where the work happens. Confirm that current instructions are available, suppliers received approved requirements, systems contain correct versions, and affected personnel can perform their tasks. A signed approval is not evidence that every downstream change took effect. Mistakes That Undermine Inspection Readiness Closing CAPAs on task completion alone: Effectiveness checks should test whether the underlying failure has been controlled. Updating labels in isolation: Assess packaging, supplier, system, documentation, and inventory consequences. Counting closures instead of evidence: Dashboards need defensible records behind their status indicators. ...

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Researchers at Queen’s University Belfast are leading a UK-wide clinical trial, offering an innovative cell therapy treatment for COVID-19 patients with acute respiratory failure.

This clinical trial, led by Professor Danny McAuley and Professor Cecilia O’Kane, both researchers from the Wellcome-Wolfson Institute for Experimental Medicine at Queen’s, is investigating the use of allogenic Mesenchymal stromal cells (MSCs) in patients with a complication known as Acute Respiratory Distress Syndrome (ARDS) caused by COVID-19.

In the most critically unwell patients with COVID-19, many develop a complication known as ARDS. In ARDS the lungs become inflamed and leaky so they fill with fluid. This causes respiratory failure and patients may require admission to intensive care and a ventilator machine to support their breathing.

A recent statement from the four UK Chief Medical Officers outlined the importance of clinical trials amidst the COVID-19 crisis. Professor Cecilia O’Kane said: “It is only through clinical trials we will be able to determine if new treatments are effective and safe in critically ill patients.”

The trial involves the use of MSCs, a type of cell derived from human tissue such as bone marrow or umbilical cord (which is otherwise discarded after the baby is born), to treat the injury to the lung caused by COVID 19. MSCs are a novel treatment that have been shown in experimental models to reduce inflammation, fight infection and improve the repair of injured tissue.

Patients in this trial, which is known as REALIST COVID 19, will be treated with a purified population of MSCs derived from umbilical cord tissue called ORBCEL-C. The ORBCEL-C therapy has been developed by scientists at Orbsen Therapeutics in Galway, Ireland. The ORBCEL-C therapeutic is manufactured under licence by the UK NHS Blood and Transplant Service for the REALIST COVID-19 trial.

The trial is being introduced as part of an existing programme of research investigating the use of MSCs in patients with ARDS. The first patient has now been recruited with plans to recruit at least 60 patients throughout the COVID-19 pandemic at multiple sites across the UK including Belfast, Birmingham and London.

Professor Ian Young, Clinical Professor at the Centre for Public Health, Queen’s University Belfast, Director of HSC R&D and Chief Scientific Advisor at the Department of Health, said: “The Health and Social Care Research & Development Division has been working with researchers across HSC to address the global problem of Coronavirus. We have contributed £230K for this vital research which will provide important evidence regarding a potential new treatment for respiratory failure, a leading cause of mortality in COVID-19. We will continue to support health research and encourage people to participate in research trials and other studies so patients can get the best possible treatment to help tackle the spread of COVID-19.”

The trial has been identified by the National Institute for Health Research (NIHR) as a national urgent public health study. It is one of a number of COVID-19 studies that have been given urgent public health research status by the Chief Medical Officer/ Deputy Chief Medical Officer for England. The study is funded by the Health and Social Care Research & Development Division and the Wellcome Trust, sponsored by the Belfast Health and Social Care Trust and supported by the NI Clinical Trials Unit, the NIHR Clinical Research Network and the Northern Ireland Clinical Research Network.

Orbsen CSO Steve Elliman noted: “While there are over 100 vaccines and therapies in development targeting the SARS-CoV-2 infection – at present there are no disease modifying therapies approved for ARDS. We’re delighted the REALIST trial was approved and listed by NIHR as an Urgent Public Health Research Study so we can continue assess the safety of the ORBCEL-C therapy in patients with ARDS.”

Sir Professor Alimuddin Zumla of University College London, a global coronavirus and infectious diseases expert said: “This is an exciting and important trial which targets rectifying the underlying causes of lung damage and has great potential of saving many lives from COVID-19. The team should be congratulated for their leadership of host-directed therapies, a concept which has not yet been explored to its full potential.”

Professor Danny McAuley is also part of an international network of researchers who are taking forward trials of umbilical cord-derived Mesenchymal stromal cells for the treatment of COVID-19: UK: (UCL- Sir Professor Azumla); Portugal (Champualimud Foundation – Professor Markus Maurer; Italy (INMI-Professor Giuseppe Ippolito) and China (Fifth Medical Center- Professor Fu-Sheng Wang.)

  1. Media inquiries to comms.officer@qub.ac.uk  
  2. About NIHR: Please visit  https://www.nihr.ac.uk/covid-19/ to learn about other studies that have been given urgent public health status and the single, national prioritisation process that has been established to prevent duplication of effort and to ensure that the resources and capacity of the health and care system to support COVID-19 research are not exceeded.
  3. About Wellcome: Wellcome exists to improve health by helping great ideas to thrive. We support researchers, we take on big health challenges, we campaign for better science, and we help everyone get involved with science and health research. We are a politically and financially independent foundation. For more information please  visit: http://wellcome.ac.uk/
  4. For further information about HSC Research & Development Division work, please visit: www.research.hscni.net

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Technology transfer moves more than manufacturing instructions. It moves process knowledge, supplier dependencies, labeling requirements, packaging specifications, and the evidence needed to demonstrate control. For medical device manufacturers, including those supporting drug-device combination products, these interfaces can become recurring sources of compliance gaps during site transitions, acquisitions, and remediation. The central problem is often not a missing procedure. It is a quality system that allows connected activities to change independently. A label revision may be approved while packaging artwork, supplier instructions, or production-system data still reflect an obsolete version. Staying inspection-ready requires manufacturers to manage these dependencies as one controlled system. 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